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Research Guide Series
Combat Stress
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Combat Stress
Combat stress has several different forms:
Combat stress reaction (CSR) – also called “shell shock” or “battle fatigue” – is a short-term effect of
battle that was most notably observed in the First World War. Symptoms include slow reaction times,
a disconnection from surroundings (the result of which is the “thousand-yard stare” often seen in
WWI photographs of shell-shocked victims), indecision, nausea, difficulty in controlling reactions
(for example, anger) and depression.
A longer-term stress reaction is Post-traumatic stress disorder (PTSD), which often develops after
severe trauma, including accidents, rape, combat and war. As well as the symptoms associated with
CSR, PTSD often manifests as flashbacks, nightmares and insomnia, and can have severe effects on
social and occupational spheres.
There has been continuous debate about the validity of CSR. During the First World War, soldiers
were classed as “wounded” if a shell-blast was thought to have caused their distress; if not, they were
classed as “sick”, which would disqualify them from receiving a pension. Many of the soldiers
executed for desertion received a posthumous pardon in 2006, when it was recognised that many of
them suffered from CSR. Accusations of malingering and cowardice were often levelled at those
suffering from CSR: most famously, General Patton slapped a soldier suffering from CSR, calling him
a “gutless bastard.1”
The treatments used for CSR have also been debated, as have the ethics of sending distressed soldiers
back into combat (most notably during the Vietnam conflict). However, the recognition and treatment
of both CSR and PTSD has improved greatly in the modern era. It has also been recognised that
peacekeeping, as well as active warfare, can lead to trauma: Canadian General Romeo Dallaire, leader
of the United Nations Assistance Mission in Rwanda, developed PTSD after being unable to intervene
in the Rwandan genocide in 1994.
This bibliography has been designed to provide a guide as to where to find information on combat
stress. Please note that the list of references below is a selection of the more relevant titles and
information on the subject. The list is not intended to be exhaustive or definitive but is an introductory
guide to some of the resources available.
Monographs
Adler, Amy B., et al (eds.). Deployment psychology: evidence-based strategies to promote
mental health in the military. Washington, DC: American Psychological Association, 2011,
294 p.
Adler, Amy B., et al (eds.). Military life: the psychology of serving in peace and combat,
volume 2: operational stress. Westport, CT: Praeger Security International, 2006, 255 p.
Asken, Michael, J. Condition Black: Stress, fear and mental toughness In Warrior mindset:
mental toughness skills for a nation’s peacekeepers. Millstadt, IL: Warrior Science Group,
2010, 254 p.
Babington, Anthony. Shell-shock: a history of the changing attitudes to war neurosis.
London: Leo Cooper, 1997, 218 p.
1
Atkinson, Rick. The Day of Battle: The War in Sicily and Italy 1943–1944. New York: Henry Holt & Co.,
2007, p. 147.
Barham, Peter. Forgotten lunatics of the Great War. New Haven, CT: Yale University
Press, 2004, 451 p.
Binneveld, Hans. From shell shock to combat stress: a comparative history of military
psychiatry. Amsterdam: Amsterdam University Press, 1997, 220 p.
Blower, Neil. Shell Shock: the diary of Tommy Atkins. Eastbourne: FireStep Publishing,
2011, 136 p.
Bracken, Patrick J., & Petty, Celia (eds.). Rethinking the trauma of war. London: Free
Association Books, 1998, 200 p.
Brewin, Chris R. Post-traumatic stress disorder: malady or myth? New Haven, CT: Yale
University Press, 2003, 271 p.
Brook, Ray. The stress of combat the combat of stress: caring strategies towards exservice men and women. Brighton: Sussex Academic Press, 2010, 344 p.
Brooks, Maj Michael L. 21st Century Combat Post-Traumatic Stress: An Effective and
Resilient Military Force. Quantico, VA: USMC Command and Staff College, 2008, 33p.
Caplan, Paula J. When Johnny and Jane come marching home: how all of us can help
veterans. Cambridge, MA: MIT Press, 2011, 282 p.
Cohen, Marjorie & Gilberd, Kathleen. The medical side of war. In Rules of disengagement:
the politics and honor of military dissent. Sausalito, CA: PoliPointPress, 2009, 226 p.
Coleman, Penny. Flashback: posttraumatic stress disorder, suicide, and the lessons of
war. Boston, MA: Beacon Press, 2006, 223 p.
Copp, Terry, & Humphries, Mark Osborne. Combat stress in the 20th Century: the
Commonwealth perspective. Kingston, ON: Canadian Defence Academy Press, 2010, 595 p.
Dandeker, Christopher, et al. Improving the delivery of cross departmental support and
services for veterans. London: King's College, 2003, 176 p.
Dickey, Maj G W. Mindfulness-based cognitive therapy as a complementary treatment
for combat/operational stress and combat post-traumatic stress disorder. Quantico, VA:
USMC Command and Staff College, 2008, 30p.
Doucette, Fred. Empty casing: a soldier’s memoir of Sarajevo under siege. Vancouver,
BC: Douglas & McIntyre, 2008, 228 p.
Fink, George. Stress of war, conflict and disaster. Amsterdam: Elsevier, 2010, 886 p.
Finkel, Daniel. Thank you for your service. New York, NY: Sarah Crichton Books, 2013,
256 p.
Finley, Erin P. Fields of combat: understanding PTSD among veterans of Iraq and
Afghanistan. Ithaca, NY: ILR Press, 2011, 221 p.
Frederick, Jim. Black hearts: one platoon's descent into madness in Iraq's triangle of
death. London: Macmillan, 2010, 439 p.
Freeman, Sharon, et al (eds.). Living and surviving in harm’s way: a psychological
treatment handbook for pre- and post-deployment of military personnel. New York, NY:
Routledge, 2009, 513 p.
Gabriel, Richard A. (ed.). Military psychiatry: a comparative perspective. New York, NY:
Greenwood Press, 1986, 214 p.
Gabriel, Richard A. No more heroes: madness and psychiatry in war. New York, NY: Hill
and Wang, 1987, 179 p.
Grossman, Dave. On killing: the psychological cost of learning to kill in war and society.
New York, NY: Back Bay Books, 2009, 377 p.
Hancock, Peter A., & Szalma, James L. (eds.). Performance under stress. Aldershot:
Ashgate, 2008, 389 p.
Helmus, Todd C., & Glen, Russell W. Steeling the mind: combat stress reactions and their
implications for urban warfare. Santa Monica, CA: Rand Corporation, 2005, 150 p.
Henden, John. Beating combat stress: 101 techniques for recovery. Malden, MA: WileyBlackwell, 2011, 150 p.
Hicks, Trevor. Post-Traumatic Stress Disorder and the law. Boca Raton, FL:
Dissertation.com, 2003, 113 p.
Hoge, Charles W. Once a warrior, always a warrior: navigating the transition from
combat to home – including combat stress, PTSD, and mTBI. Guilford, CT: GPP Life,
2010, 303 p.
Holden, Wendy. Shell shock. London: Channel 4 Books, 1998, 192 p.
Hunt, Nigel, C. Memory, war and trauma. Cambridge: Cambridge University Press, 2010,
232 p.
Johnson, James D. Combat trauma: a personal look at long-term consequences. Lanham,
MD: Rowman & Littlefield, 2010, 197 p.
Jones, Edgar, & Wessely, Simon. Shell shock to PTSD: military psychiatry from 1900 to
the Gulf War. Hove: Psychology Press, 2005, 300 p.
Laurence, Janice H., & Matthews, Michael D. The Oxford handbook of military
psychology. Oxford: Oxford University Press, 2012, 417 p.
Lawhorne, Cheryl, & Philpott, Don. Combat-related traumatic brain injury and PTSD: a
resource and recovery guide. Lanham, MD: Government Institutes, 2010, 270 p.
Lee, Harry André, & Jones, Edgar (eds.). War and health: lessons from the Gulf War.
Chichester: John Wiley & Sons, 2007, 154 p.
McCain, Cilla. Murder in Baker Company: how four American soldiers killed one of
their own. Chicago, IL: Chicago Review Press, 2010, 282 p.
Mental Health Foundation. Need 2 know: the mental health of veterans - executive
briefing. London: Mental Health Foundation, 2010.
NATO Standardization Agency. A psychological guide for leaders across the deployment
cycle (STANAG 2565). Brussels: NATO Standardization Agency, 2011, var pag.
O’Connor, Richard B. Collateral damage: how can the Army best serve a soldier with
post-traumatic stress disorder? Arlington, VA: Institute of Land Warfare, 2009, 28 p.
Paulson, Daryl S., & Krippner, Stanley. Haunted by combat: understanding PTSD in war
veterans including women, reservists, and those coming back from Iraq. Lanham, MD:
Rowman and Littlefield, 2010, 203 p.
Reid, Fiona. Broken men: shell shock, treatment and recovery in Britain, 1914-1930.
London: Continuum, 2011, 214 p.
Rivers, W. H. R. Instinct and the unconscious: a contribution to a biological theory of the
psycho-neuroses. 2nd edition. Cambridge: Cambridge University Press, 1922, 252 p.
Scurfield, Raymond M. Post-traumatic stress disorder and the healing from the war In Weist,
Andrew, & Barbier, Mary Kathryn (eds.). America and the Vietnam war: re-examining the
culture and history of a generation. New York, NY: Routledge, 2010, 324 p.
Shephard, Ben. A war of nerves. London: Jonathan Cape, 2000, 487 p.
Sher, Leo, & Vilens, Alexander (eds.). War and suicide. New York, NY: Nova Science
Publishers, 2009, 306 p.
Sherman, Nancy. The untold war: inside the hearts, minds, and souls of our soldiers. New
York, NY: W. W. Norton, 2010, 338 p.
Sills, Peter. Toxic war: the story of Agent Orange. Nashville, TN: Vanderbilt University
Press, 2014, 285 p.
Sinclair, Robert and Britt, Thomas. Building psychological resilience in military personnel:
theory and practice. Washington, DC: American Psychological Association, 2013, 268 p.
Smith, G. Elliott, & Pear, T. H. Shell shock and its lessons (1917). Whitefish, MT:
Keesinger Publishing, 2010, 135 p.
Southard, E. E. Shell-shock and other neuropsychiatric problems: presented in five
hundred and eighty-nine case histories from the war literature, 1914-1918, parts 1 & 2.
Facsimile of 1919 Edition. Whitefish, MT: Kessinger Publishing, 2010, var pag.
Tanielian, Terri L., & Jaycox, Lisa (eds.). Invisible wounds of war: psychological and
cognitive injuries, their consequences, and services to assist recovery. Santa Monica, CA:
RAND Corporation, 2008, 453 p.
United Kingdom. War Office Committee. Army. Report of the War Office Committee of
Enquiry into “shell-shock”. Cmd. 1734. London: HMSO, 1922, 215 p.
Walters, David J. After the Falklands: finally overcoming the nightmare of PTSD.
Penryn: Ecademy Press, 2007, 112 p.
Winter, Jay. Chapter 13: Shell shock. In The Cambridge history of the First World War,
volume III: civil society, edited by Jay Winter. Cambridge: Cambridge University Press,
2014, 763 p.
Wood, Jake. Among you: the extraordinary true story of a soldier broken by war.
Edinburgh: Mainstream Publishing, 2013, 448 p.
Periodical Articles
Barker, Michael. Medicine and the GWOT: what we've learned, what it's cost, and the
veterans crisis to come. Armed Forces Journal, March 2013, pp. 16-32
Black, James. Post-traumatic stress disorder: A personal story of fighting back. The Armor
and Cavalry Journal, Vol. 2, No. 3, May-June 2009, pp. 23-25.
Card-Mina, Mary. Leadership and post-traumatic stress symptoms. Military Review, Vol.
91, No. 1, January-February 2011, pp. 47-53.
Darwin, Janie. When war hits home. US Naval Institute Proceedings, Vol. 137, No. 2,
February 2013, pp. 50-54
Garske, Gregory. Military-related PTSD: A Focus on the Symptomatology and Treatment
Approaches. Journal of Rehabilitation, Vol. 77, No. 4, October/December 2011, pp. 31-36.
Grice, Michael. Leading with PTSD: suffering from what they have experienced. Marine
Corps Gazette, Vol. 96, No. 8, August 2012, pp. 12-14.
Kamienski, Lukasz. Helping the postmodern Ajax: Is managing combat trauma through
pharmacology a Faustian bargain? Armed Forces & Society, Vol. 39, No. 3, July 2013, pp.
395-414
MacManus, Deirde. The mental health of the UK armed forces in the 21st century:
resilience in the face of adversity. Journal of the Royal Army Medical Corps, 2014, pp. 1-6.
Mattila, Amy M. U.S. Army combat operational stress control throughout the deployment
cycle: A case study. Work, Vol. 38, No. 1, February 2011, pp. 13-18.
Mulligan, Kathleen, et al. Mental health of UK military personnel while on deployment in
Iraq. The British Journal of Psychiatry, Vol. 197, 2010, pp. 405-410.
Ochberg, Frank. An injury, not a disorder. Military Review, Vol. XCIII, No. 2, March-April
2013, pp. 96-99.
Reger, Greg M., & Moore, Bret A. Combat Operational Stress Control in Iraq: Lessons
Learned During Operation Iraqi Freedom. Military Psychology, Vol. 18, No. 4, October
2006, pp. 297-307.
Riggs, David, & Sermanian, Diana. Prevention and Care of Combat-Related PTSD:
Directions for Future Explorations. Military Medicine, August 2012 Supplement, pp. 14-20.
Schneider, James. A Leader's Grief: T.E. Lawrence, Leadership, and PTSD. Military
Review, Vol. 92, No. 1, January/February 2012, pp. 75-80.
Stagner, Annessa C. Healing the soldier, restoring the nation: representations of shell shock
in the USA during and after the First World War. Journal of Contemporary History, Vol.
49, No. 2, April 2014, pp. 255-274
Steele, Dennis. Soldier’s minds: no place to retreat. Army, Vol. 60, No. 5, May 2010, pp. 3638.
Van Norman, Jessica. Lifting the fog of war: combating post-traumatic stress disorder.
Marine Corps Gazette, Vol. 94, No. 7, July 2010, pp. 69-73.
Websites
Kings Centre for Military Health Research
http://www.kcl.ac.uk/kcmhr/ [Accessed 19.02.2015]
British Legion: Meeting the healthcare needs of veterans
http://www.britishlegion.org.uk/media/1163063/veteranshealthcareneedsgps.pdf
[Accessed 28.05.2015]
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Compiler: Rhys Thomas, 2011
Updated: Luke Johnstone, 2015
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